摘要
目的探讨微通道与标准通道经皮肾镜取石手术(PCNL)对肾血流动力学的影响。方法收集2011年1月至2013年1月邹城市人民医院泌尿外科收治的肾结石患者106例,根据随机数字表法分为微通道组(55例)和标准通道组(51例)。微通道组采用微通道PCNL治疗,标准通道组采用标准通道PCNL治疗,观察两组患者术前、术后30 d肾血流动力学的变化情况。结果微通道组患者手术持续时间显著长于标准通道组[(128±10)min比(114±7)min];但术中出血量、术中输液量显著少于标准通道组[(122±24)m L比(148±40)m L,(1323±213)m L比(1544±266)m L,P<0.05]。两组一期手术结石清除率比较差异无统计学意义(P>0.05);术后30 d,微通道组患者肾主动脉、段间动脉、叶间动脉的Vmax和S/D分别为(85±7)cm/s和2.99±0.23、(56±5)cm/s和2.67±0.07、(43±4)cm/s和2.58±0.06,明显高于标准通道组的(73±8)cm/s和2.82±0.26、(48±6)cm/s和2.60±0.12、(36±4)cm/s和2.50±0.07;RI分别为0.54±0.11、0.52±0.13、0.45±0.04,明显低于标准通道组的0.63±0.07、0.61±0.10、0.57±0.08(均P<0.05)。结论采用PCNL治疗肾结石时,通道选择应认真设计,尽可能地选择微通道,以减少手术本身对肾脏结构及功能的影响。
Objective To study the effect of micro channel and standard channel percutaneous nephro-lithotomy（ PCNL） on renal hemodynamics.Methods A total of 106 patients with renal calculi admitted in Urology Department of Zoucheng People′s Hospital from Jan.2011 to Jan.2013 were selected,and divided into micro channel group （ n =55 ） and standard channel group （ n =51 ） according to random digit table method.Patients in micro channel group were treated with micro channel PCNL,while patients in standard channel group were treated with standard channel PCNL,the renal hemodynamics changes before operation and 30 days after operation were observed.Results Operation time of the micro channel group was signifi-cantly longer than the standard channel group [ （ 128 ±10 ） min vs （ 114 ±7 ） min ];but the intraoperative bleeding and transfusion amounts were significantly less than the standard channel group[（122 ±24） mL vs （148 ±40） mL,（1323 ±213） mL vs （1544 ±266） mL] （P〈0.05）.The stone clearance rate of primary operation between the two groups had no statistically significant difference（P〉0.05）;30 days after opera-tion,in micro channel group,Vmax and S/D of renal artery,segmental artery,interlobar artery were respec-tively （85 ±7） cm/s and 2.99 ±0.23,（56 ±5） cm/s and 2.67 ±0.07, （43 ±4） cm/s and 2.58 ±0.06, higher than those in standard channel group[（73 ±8） cm/s and 2.82 ±0.26,（48 ±6） cm/s and 2.60 ± 0.12,（36 ±4） cm/s and 2.50 ±0.07];while RI of renal artery,segmental artery,interlobar artery in the micro channel group were 0.54 ±0.11,0.52 ±0.13,0.45 ±0.04,lower than those in standard channel group[0.63 ±0.07, 0.61 ±0.10, 0.57 ±0.08]（P 〈0.05）.Conclusion While treating renal calculi with PCNL,channel selection should be designed carefully,and it is much better to choose micro channel,in order to reduce the impact of the operation on renal structure and functions .
出处
《医学综述》
2015年第11期2111-2112,F0003,共3页
Medical Recapitulate
关键词
经皮肾镜取石手术
肾血流动力学
微通道
标准通道
Percutaneous nephrolithotomy
Renal hemodynamics
Micro channel
Standard channel
